Nepal: Latest MSF Updates

Emergency Aid for Nepal

A 7.8-magnitude earthquake shook the Kathmandu Valley before noon on April 25. Although the extent of the damages is still unknown, initial reports say houses and buildings collapsed in Kathmandu and surrounding areas.

Tremors were also strongly felt in northern India, in the states of Bihar and Uttar Pradesh.

This page will be updated regularly with new information on our emergency response as the situation develops. Follow @MSF_USA on Twitter for updates.

Please note that we are not recruiting for the current emergency response in Nepal. MSF does not recruit for specific locations or emergencies. Anyone interested in working in the field with MSF can apply online but must be open to working in the country to which they are assigned. Assignment is based on the needs of the field and the skills of the field worker.

Update: May 15, 2015

Nepal has been hit by two earthquakes in less than three weeks, killing thousands, injuring tens of thousands, and leaving millions more with the burden of rebuilding their lives. Doctors Without Borders/Médecins Sans Frontières (MSF) teams, who were already on the ground soon after the first quake, continue working to reach and assist those affected. They are continuing to prioritize people in remote mountain villages who have borne the brunt of the destruction and remain isolated from help.

MSF teams mobilized shortly after the first 7.8-magnitude earthquake hit on April 25 and began providing medical services and shelter and food materials by helicopter to people in isolated villages. These teams were able to respond almost immediately following the second, 7.3-magnitude earthquake on May 12. In remote villages like Singati, Marbu, Yanglakot, and Lapilang, MSF evacuated patients in critical condition to hospitals in Kathmandu. The organization is now conducting assessments following the second earthquake in order to re-adjust its assistance according to the needs that have arisen from the two quakes.

“In some areas, there has been up to 90 percent destruction,” said Dan Sermand, MSF country director in Nepal. “Hospitals and health centers have been damaged by the two quakes, leaving many people with no access even to the most basic health care. Up until yesterday, there were still landslides ongoing in some mountainous areas that we assessed. In some areas, whole villages have now been brought down, compounding an already dire situation as many people had already lost their homes in the first earthquake.”

Health Care

In many districts, hospitals and health centers were flattened, and those still standing have numerous cracks making them susceptible to collapse. Bhaktapur hospital received a mass influx of wounded people after the second earthquake, prompting MSF to donate dressing kits and medicine.

In Dhading, Gorkha, Rasuwa, Sindhupalchowk, and Nuwakot districts, MSF is providing medical and psychological services to those in need, some of whom had not received any medical assistance since the first quake hit.

In Dolakha district, the epicenter of the second earthquake, MSF tended to people in critical condition on site and evacuated those with severe injuries, including fractured skulls, to hospitals in Kathmandu for further medical attention.

In Arughat, in Gorkha district, MSF’s 20-bed inflatable hospital has been operational since May 8 and now sees patients affected by the two earthquakes as well as people from nearby communities. It has surgical capacity; maternity, emergency, and general wards; and a mental health program. MSF is also working with the Nepali Ministry of Health to offer outpatient services, and supporting drug supply, medical training, and the referral system for the hospital. An average of 100 patients are treated per day in the outpatient department, mainly suffering from respiratory tract infections, diarrhea, and wounds sustained from the earthquake. In the emergency room, MSF is treating an average of 15 patients per day, mainly suffering from fractures and wounds. The first baby was born in the maternity ward on May 12.

“Most of the health facilities in Gorkha district have collapsed and the Arughat hospital is helping provide the much-needed secondary health care in the area,” said Dr. Managama Guyguy, medical coordinator in Nepal. “There are people who tell us they have walked for five days to the Arughat hospital. This goes to show just how severely the earthquakes have destroyed the health care system.”

MSF is also providing mental health services and psychosocial sessions in villages in Nuwakot, Gorkha, Rusuwa, and Sindhupalchowk districts. In the Arughat hospital MSF is providing psychological care to patients and local staff who were traumatized by the earthquake.

Shelter and Food

Shelter was already a major need before the second earthquake, and the situation is now even worse. “My house was cracked in the first earthquake; the second earthquake finished it,” says Rajkumar Pakhrin, an MSF administration assistant from Mirge village in Dolakha District. “I’m broken, I have lost my property and my cattle are no more, but I’m happy that my family was not in the house when this happened. They were in a displacement camp for fear of the house collapsing. And they were right.”

MSF teams have distributed over 2,300 shelter and hygiene kits in 20 of the most-affected villages across Rasuwa, Sindupalchok, and Gorkha districts. Teams have also begun distributing reconstruction material such as iron sheets and nails in some villages of Dhading, Sindhupalchowk, and Rasuwa districts.

Food, mainly rice and high-energy biscuits, has been distributed in Rasuwa, Sindupalchok, and Dhading districts.

Water and Sanitation

MSF has installed water supplies and is building latrines in Chuchibati camp in Kathmandu. Bladder tanks have also been set up in some villages in Rasuwa district. The team also provided the communities of Gumpatang, Tembatang, and Nimlung of Sindhupalchowk district with pipes and tanks to restore their gravity water system.

Transport Challenges

Aircraft remain the only means of transport to reach mountainous areas where roads have been damaged or blocked. Since large helicopters cannot land in remote villages—where most of MSF’s work is concentrated—small helicopters are the only option. These have very limited flight capacity, which restricts the amount of cargo that can be transported.

“In a few weeks the monsoon-season starts and people can no longer live outside,” says MSF Emergency Coordinator Peter Paul de Groote. “By then the remote areas will be very difficult to reach. The window of opportunity is now. We are making every effort to get shelter to these villages before this window closes.”

Historical

MSF has worked in Nepal since 2002. Teams provided health care to people affected by the conflict between government forces and the Communist Party of Nepal which lasted from 1996 until 2006, and by the resurgence of violence that accompanied a chaotic peace process.

MSF worked where help was most needed, including in basic health care, reproductive health care, and water and sanitation provision.

Despite Nepal’s struggles with political stability after the peace process, MSF is now leaving the country as government agencies and developmental organisations start to take a longer-term approach to covering the people’s health needs. Capacity-building and training on the job are consequently key objectives in the remaining MSF projects.

Teams worked to increase knowledge about reproductive health and called for better access to good-quality public health services. Through radio announcements and education, MSF also addressed the issue of oxytocin misuse. The drug, used to stimulate contractions in pregnant women, is widely misused. This can result in fetal and neonatal deaths, and ruptures of the uterus.

In May, MSF handed over programs in the mountainous Kalikot district, where MSF had offered basic and secondary health care, Tuberculosis (TB) treatment, and emergency services with a special focus on health care for pregnant women and children under five. In 2009, MSF carried out more than 10,000 consultations and assisted with 192 deliveries.

In December, MSF handed over its last remaining program in the Terai region of Nepal, which provided free medical services, emergency consultations, maternal health care, and treatment of acutely malnourished children. In the areas affected by internal unrest MSF used mobile clinics in the most neglected areas and transferred patients needing more care to its facility at Gaur District Hospital. MSF carried out more than 10,000 consultations and assisted more than 1,300 deliveries.

In the areas where it worked, MSF leaves behind an improved level of care for mothers and newborns, and better trained staff.